Aktuelle Aspekte der Rolle des Gehirns beim Diabetes mellitus

Zusammenfassung

Neuere Erkenntnisse und pathogenetische Modelle zur Wirkung von Glukose, Insulin und Leptin am Gehirn einschließlich einer zerebralen Insulinresistenz unterstreichen die Rolle des Gehirns nicht nur als “Opfer” des Diabetes, sondern auch als (Mit-)Täter im komplexen metabolischen Geschehen beim Diabetes. Insulin könnte über eine Konkurrenz mit dem Beta-Amyloid abbauenden “Insulin-Degrading-Enzyme” (IDE) in die Pathophysiologie der Alzheimer-Demenz verwickelt sein.

Summary

Recent insights and proposed pathophysiological mechanisms concerning the effects of glucose, insulin, and leptin on the brain including cerebral insulin resistance suggest a role of the brain not only as “victim” of diabetes, but also as a “culprit” in the complex metabolic disturbances of diabetes.

Schlüsselwörter

Diabetes mellitus - Gehirn - Demenz - Depression

Keywords

Diabetes mellitus - brain - dementia - depression

• Literatur

• 1 Ahima RS, Qi Y, Singhal NS. Adipokines that link obesity and diabetes to the hypothalamus. Prog Brain Res 2006; 153: 155-174.
• 2 Banks WA. The blood-brain barrier as a regulatory interface in the gut-brain axes. Physiol Behav 2006; 89: 472-476.
• 3 Biessels GJ, Staeckenborg S, Brunner E, Brayne C, Scheltens P. Risk of dementia in diabetes mellitus: a systematic review. Lancet Neurol 2006; 05: 64-74.
• 4 Demuro G, Obici S. Central Nervous system and control of endogenous glucose production. Curr Diab Rep 2006; 188-193.
• 5 Fehm HL, Kern W, Peters A. The selfish brain: competition for energy resources. Prog Brain Res 2006; 153: 129-140.
• 6 Pathan AR, Viswanad B, Sonkusare SK. et al. Chronic administration of pioglitazone attenuates intracerebroventricular streptozotocin induced memory impairment in rats. Life Sci 2006; 79: 2209-2216.
• 7 Pedersen WA, McMillan PJ, Kulstad JJ. et al. Rosiglitazone attenuates learning and memory deficits in Tg2576 Alzheimer mice. Exp Neurol 2006; 199: 265-273.
• 8 Plum L, Belgardt BF, Bruning JC. Central insulin action in energy and glucose hemoeostasis. J Clin Invest 2006; 116: 1761-1766.
• 9 Prodi E, Obici S. Minireview: the brain as a molecular target for diabetic therapy. Endocrinology 2006; 147: 2664-2669.
• 10 Qiu WQ, Folstein MF. Insulin, insulin-degrading enzyme and amyloid-beta peptide in Alzheimer´s disease: review and hypothesis. Neurobiol Aging 2006; 27: 190-198.
• 11 Schwartz MW, Porte Jr D. Diabetes, obesity, and the brain. Science 2005; 375-379.
• 12 Schweiger U, Peters A. Das “Selfish-brain-Paradigma”. Implikationen für die Psychobiologie der Depression. Psychosom Konsiliardienstpsychiatr 2007; 5-9.
• 13 Steen E, Terry BM, Rivera EJ, Cannon JL, Neely TR, Tavares R, Xu XJ, Wands JR, de la Monte SM. Impaired insulin and insulin-like growth factor expression and signaling mechanisms in Alzheimer’s disease--is this type 3 diabetes?. J Alzheimers Dis 2005; 07: 63-80.
• 14 Zhao Z, Ho L, Wang J, Qin W. et al. Connective tissue growth factor (CTGF) expression in the brain is a downstream effector of insulin resistant-promotion of Alzheimer´s disease and beta-amyloid neuropathology. FASEB J 2006; 19: 2081-2082.
• 15 Dietrich W, Erbguth F. Neurologische Komplikationen bei Diabetes mellitus. Nervenheilkunde 2007; 26: 747-458.